title: Long-term results of cervical myelopathy due to ossification of the posterior longitudinal ligament with an occupying ratio of 60% or more.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  We sought to determine the long-term outcomes of laminoplasty versus anterior decompression and fusion in the treatment of cervical myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) and to ascertain what factors should be considered in selecting appropriate surgical procedure.
  
  
  BACKGROUND
  There are little data about long-term results of cervical myelopathy due to OPLL with an occupying ratio 60% or more.
  
  
  METHODS
  We retrospectively studied 27 patients having OPLL with an occupying ratio 60% or more and a follow-up period of at least 2 years. Clinical outcome was evaluated using Japanese Orthopaedic Association scores and recovery rates (≥75%, excellent; 50%-74%, good; 25%-50%, fair; and <25%, poor).
  
  
  RESULTS
  The mean age and the mean duration of follow-up were 57 years and 10.2 years. The mean Japanese Orthopaedic Association score was 9.3 before surgery and 12.4 at the final follow-up examination. There were 15 patients in the laminoplasty group (LAM group) and 12 patients in the anterior decompression and fusion group (ADF group). The ADF group had a significantly better recovery rate at final evaluation (53% vs. 30%; P = 0.04), a longer duration of surgery (314 vs. 128 min; P < 0.01), and greater blood loss (600 vs. 240 mL; P < 0.01) than did the LAM group. In the LAM group, 4 patients with excellent or good results had a significantly larger degree of cervical lordosis (30°vs. 10°; P = 0.002) than others.
  
  
  CONCLUSIONS
  The ADF group had a significantly better recovery rate than the LAM group, although the degree of surgical invasiveness was high. ADF is generally recommended for OPLL with an occupying ratio 60% or more.
  
  
  METHODS
  3.
authors.affiliation: *Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan †Department of Orthopedic Surgery, Osaka Rosai Hospital, Osaka, Japan; and ‡Department of Orthopedic Surgery, Osaka Koseinenkin Hospital, Osaka, Japan.
authors.forename: Takahito
authors.initials: T
authors.lastname: Fujimori
authors.forename: Motoki
authors.initials: M
authors.lastname: Iwasaki
authors.forename: Shinya
authors.initials: S
authors.lastname: Okuda
authors.forename: Shota
authors.initials: S
authors.lastname: Takenaka
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kashii
authors.forename: Takashi
authors.initials: T
authors.lastname: Kaito
authors.forename: Hideki
authors.initials: H
authors.lastname: Yoshikawa
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome